Nilotinib and Liver Health — May 2024

Nilotinib can help treat chronic myeloid leukemia, but it can also affect the liver. In May 2024 we published a focused piece that explains what liver problems look like, how doctors check for them, and what patients should do right away if something goes wrong.

What to watch

Watch for clear signs: yellowing of the skin or eyes (jaundice), dark urine, pale stools, strong nausea, belly pain on the right side, unexplained tiredness, or itching. These often show up before serious damage. Lab signs matter too—doctors look at ALT, AST and bilirubin to spot trouble early.

People with pre-existing liver disease, hepatitis B or C, heavy alcohol use, older age, or who take other liver-impacting drugs are at higher risk. If you fall into one of these groups, tell your doctor before you start Nilotinib so they can set up closer monitoring.

How monitoring usually works

Most clinicians get baseline liver tests before starting Nilotinib, then check blood regularly during the first few months. Many providers test every 2–4 weeks early on, then space checks out if results stay stable. If levels rise, doctors repeat tests more often until they see a clear trend.

Screening for hepatitis B and C before treatment is common practice because hidden infections can flare when you take cancer drugs. If you test positive for hepatitis, your doctor will discuss additional precautions or specialist referral.

What happens if tests are abnormal? Small, temporary rises in liver enzymes are often watched without stopping the drug. Bigger jumps or symptoms usually lead to pausing Nilotinib, repeating labs, and deciding whether to restart at a lower dose or switch therapy. Severe liver injury is rare but needs urgent care and sometimes hospitalization.

Medications and supplements can increase liver risk. Avoid heavy alcohol while on Nilotinib. Tell your medical team about pain relievers like acetaminophen, cholesterol drugs, certain antibiotics, antifungals, herbal supplements, and anything else you take. Your doctor will check for interactions and adjust doses as needed.

Practical tips: keep a simple list of all your medicines, bring it to every visit, and ask for clear lab schedules. If you notice any worrying symptoms, call your oncology clinic rather than waiting. For sudden severe symptoms—confusion, severe abdominal pain, high fever, heavy bleeding—seek emergency care.

The full May article breaks down lab numbers, gives examples of when doctors normally pause treatment, and lists common interacting drugs. If you're on Nilotinib or about to start it, reading that piece will help you talk with your team and stay safer while on therapy.